Form WD-1 - Wrongful death citation
Form WD-1
(Wrongful Death Citation)
CITATION
THE PEOPLE OF THE STATE OF NEW YORK
BY THE GRACE OF GOD, FREE AND INDEPENDENT,
TO: ____________
____________, an infant over the age of 14 years
of ____________, New York
[list other parties]
____________ being persons interested as creditors, legatees, devisees, beneficiaries,
distributees or otherwise of the estate of ____________, deceased, who at the time of death resided____________
at ____________,
(Street/Number) (City, Village/Town) (State) (Zip Code)
A petition having been duly filed by ____________,
who is domiciled at ____________,
(Street/Number) (City, Village/Town) (State) (Zip Code)
YOU ARE HEREBY CITED TO SHOW CAUSE before the Surrogate's Court, ____________
County, at ________, New York on ________, 19________, at 9:30 a.m.,
WHY the account of the proceedings of ________ as administrat ________ of the estate of ________, deceased, a copy of which is attached, should not be judicially settled, and
WHY the administrat________ should not be empowered to compromise and settle a certain claim for wrongful death against ________ for the sum of $________ and to discontinue any claim for conscious pain and suffering, and
WHY the provisions in the limited Letters of Administration issued to the petitioner on ________ 19________, restraining the compromise or collecting upon the aforesaid claim and cause of action, should not be modified to permit said compromise, and
WHY the filing of a bond should not be dispensed with, and
WHY the defendant, ____________, or defendant's insurance company, should not pay
to ________, Esqs., out of the proceeds of the settlement for the claim for wrongful death, the sum of $________ as and for attorneys' fees, together with disbursements in the sum of $________, and
WHY the entire recovery of $________ should not be allocated to the cause of action for decedent's wrongful death, and
WHY, the balance of the settlement, to wit the sum of $ ________, should not be distributed to those distributees having sustained a pecuniary loss as follows: ____________% of the balance to
____________, widow/widower of decedent; ________% of the balance to
________, child of decedent; ________% of the balance to ________, child of decedent, and
WHY the claim of ________ should not be rejected, as a nondistributee, and
WHY the claim of ________ in the amount of $ ________ should not be rejected, and
WHY upon payments as hereinbefore mentioned the said ________ should not be permitted to execute and deliver general releases and all other necessary papers to the defendant, ________, or defendant's insurance company, releasing them from all claims against them arising out of the aforesaid action for wrongful death, together with any other papers necessary to effectuate the said compromise.
Dated, Attested and Sealed, ________, 19________.
HON. ____________
Surrogate, County of
(L.S.)
______________
Clerk of the Surrogate's Court
WD-2 (4/98)
ATTORNEY
Name of Attorney:____________ Tel. No.: ________
Address of Attorney: ____________
(Street/Number) (City, Village/Town) (State) (Zip Code)
This citation is served upon you as required by law. You are not obliged to appear in person. You have a right to have an attorney appear for you. If you fail to appear it will be assumed that you do not object to the relief requested.
WD-2 (4/98)